~ A periodic blog on matters health, union, social justice, and the occasional random rant

Monthly Archives: November 2012

Today marks the one year anniversary of one of my favourite moments from the EBA 2011/12 campaign. Three days after nurses and midwives unanimously voted to escalated protected action to include bed closures the Baillieu government sought to have our protected action terminated, on the grounds that it may cause the public to come to harm.

Health Minister David Davis held a press conference to report on the court proceedings, and announced that the Ombudsman had ordered the beds opened. He was then corrected by a reporter – the Ombudsman had actually found there was not an immediate need to take action against ANF (Vic. branch). And here, preserved for posterity, is Minister Davis’s response: http://www.youtube.com/watch?v=4av_-HUwqJ4

That was 365 days ago. And in 745 days, when I vote, my electoral decisions will be heavily informed by the Baillieu governments’ attitudes and behaviour towards Victoria’s nurses, midwives, teachers, TAFE staff and students, ambos, fire fighters, SES staff and volunteers, forestry employees, construction workers… Still counting, Mr Baillieu.

I’m Lisa Fitzpatrick, a nurse of 31 years, and the Secretary of the ANF (Victorian branch). Our hospitals are now beyond capacity and demand is increasing, The Baillieu government has rejected fifty ANF productivity improvements. They’ve said “no” to the one extra emergency nurse, who could free up ambulances and paramedics. The government’s plan is about saving money, not lives.
Mr Baillieu, don’t ask nurses and midwives to do more with less – respect our work. Voice your support at respectourwork.com.au
Authorised by Lisa Fitzpatrick, Secretary, ANF (Victorian branch)

At the time, and this continues to be a problem a year later, ambulance ramping was endemic – Frankston hospital, which is now the closest main hospital from Portsea up, was particularly hit but no major hospitla was exempt.

Ramping is where, because the workload of an Emergency Department makes in unsafe to take over their treatment, patients brought in by ambulance must be cared for by paramedics. An additional ED nurse would free up three vehicles and six paramedics, allowing faster ambulance response times, quicker patient processing, and reducing paramedic frustration, burnout and fatigue, while also facilitating smoother ED running and improved patient care.

The Baillieu government rejected out of hand ANF’s proposal to increase ED staffing at known peak times, stating that this would constitute a cost to the nursing budget but a productivity gain for the Ambulance Service. Forget the fact that the delays caused by ramping spill over for hours, to all patients in the department (lengthening admission times, increasing fatigue and the likelihood of mistakes) – this refusal is a clear indication that the government sees the public health system as discrete elements rather than an interconnected whole; it would rather have short-term financial gain then a cohesive, smoothly functioning system, even though the latter is both more productive and less expensive.

It’s been a year, and as long as ambulances ramp, emergency departments are over capacity, and as long as I live, I will remember. 751 days, Mr Baillieu – and counting.

Ambulance ramping at the Austin last year (photo courtesy of the Herald-Sun)

On this day last year The Age published a leaked Cabinet-in-confidence document from March – though Premier Baillieu, Health Minister Davis and VHIA CEO Alec Djoneff had repeatedly publicly stated that they were interested in genuine negotiations, the leaked document proved that their aims were to replace qualified, registered nurses and midwives with minimally trained aides, to weaken or wholly kill nurse/midwife: patient ratios, introduce short shifts and split shifts, and cut the overall Victorian nursing and midwifery budget by 4%, or $104 million.

We know from the Kennett years that workload, far more than pay rates, influences how willing nurses and midwives are to stay in their professions. As patients become steadily more acute, with increasing comorbidities and shortening lengths of stay, nurses and midwives are already doing more with less. To add to this demanding workload by reducing educated, registered staff, to make us also responsible for the practice of unaccountable health assistants, and to staff wards and departments on projections of peak activity demonstrated a total ignorance of what our roles are, what our shifts are like, and of the very real difference skilled care makes to patient outcomes.

It is one thing to negotiate vigorously – that’s part of the process. It’s one thing to ask for more than you’re prepared to settle for – that’s standard. It is quite another thing to blatantly, repeatedly, undeniably lie and negotiate in bad faith. These lies, for me, represent the lack of integrity this government has.

The release of the Cabinet-in-confidence submission marked a turning point. Though previously prepared to fight to maintain and improve nursing and midwifery conditions, as I had in every previous Award and EBA negotiation since 1992, this is the anniversary of my militancy. I would not, and will not, allow this to stand.

In 753 days, or two years, three weeks and two days, Victoria will go to the polls. And I will do everything I can to ensure that the Victorian coalition makes history as the first Party in over half a century to lose after only one term.

365 days ago ANF (Vic. branch) members attended the first meeting of the 2011 EBA campaign. The members resolved that:

this mass meeting of members of the Australian Nursing Federation (Vic Branch) having heard a report back from the Secretary on progress of EBA negotiations hereby resolve as follows:
1. To call on the Baillieu Government to respect our work and reach agreement with the ANF to protect and
expand nurse to patient ratios, provide a minimum 18.5% wage increase over 4 years and address other
essential elements of our claim; and
2. To endorse the commencement of the following protected industrial action from 7.00am Thursday 10
November 2011as applicable to our respective workplaces:
a. in all areas except mental health, a ban on the collection and entry of any data that is not required by
law to be entered into the patient record and a refusal to record, collect and complete data required by the
employer, in the nature of:
• outcome measures,
• vehicle log books,
• invoicing,
• statistical data,
• contact sheets,
• daily returns/bed movements,
• pre, intra and post-operative data not required by law,
• staff attendance, including in relation to attendance or non-attendance at ANF meetings,
• staff industrial activity reports, including the recording of industrial action by means of asking
or answering of questions in relation to the industrial action.
provided that the ban and refusal will not otherwise threaten to endanger anyone’s personal safety, or their
life, health or welfare.
b. mental health ANF Members to refuse to record, collect and complete any mandatory data required by
the employer including outcome measures, vehicle log books, statistical data, contact sheets, PR 1s, 2s
and 5s, and any non-clinical/administrative paper work, including in relation to staff attendance, or nonattendance
at ANF meetings; and staff industrial activity reports, including the recording of industrial action
by means of asking or answering of questions in relation to the industrial action.
provided that the ban and refusal will not otherwise threaten to endanger anyone’s personal safety, or their
life, health or welfare.
c. mental health ANF Members to refuse to attend and participate in any meeting of service activity that is
not fully back filled and refuse to attend and participate in any non-clinical meeting or activity.
d. all members will wear t-shirts, badges and stickers relating to the proposed enterprise agreement, and
distribute and post union campaign materials, written communications and stickers in support of the
proposed enterprise agreement, and to engage with media, staff, patients, visitors, residents and their
families about the proposed agreement.
e. all members to ban the completion of any paperwork and electronic forms in aged care facilities (including
ACFI/RCS documentation) other than that which is directly related to the documenting of resident care and
which otherwise threatens to endanger anyone’s personal safety or their life, health or welfare.
f. all members will commence and finish duty at the rostered times and ban the working of overtime unless
that overtime is approved by the Employer, in writing, in advance of the overtime commencing, provided
that the ban and refusal to work overtime will not otherwise threaten to endanger anyone’s personal safety,
or their life, health or welfare
3. To meet again on Friday 11 November 2011 at Festival Hall at 2.00pm to hear a further report back and
consider what action needs to be taken in the event that an acceptable offer is not made to Victorian nurses
and midwives.
CARRIED UNANIMOUSLY (source)

Though the government’s Log of Claims was a little more alarming than usual, with its focus on employee flexibility, at this point I (as a rank-and-file member) had no idea that it was going to go any differently than the EBA and Award negotiations I’d helped fight for over the past two decades – for some reason, even though Victoria’s nurses and midwives have every time demonstrated our collective will, every State government makes us take action before settling down to negotiate.

I, and many other members, assumed it would be the same this time – a few days, or even a couple of weeks of closed beds, which is inevitably the only action that makes an impact; perhaps an escalation in bed closure goals (we usually start with a 1 in 4 aim then raise this to 1 in 3), then agreement to reopen the beds in exchange for genuine negotiation.

I haven’t spoken about this with ANF staff, so though I know they were taken by surprise by just how protracted and bitter things got, I don’t know if they suspected things would be different this time around, nor when they discovered that our 2011 campaign would break records and make history.

A quick, post night-duty reminder: in 756 days Victorians go to the polls – nurses and midwives, remember the fight we had, the fact that the Mental Health EBA (though close) still isn’t finalised, that the Baillieu government’s determination to stick to the appearance of a self-imposed 2.5% salary cap means bank + agency nurses got none of the CPD allowance, and then look around you.

Look at teachers, fighting for parity with other states, in a profession that’s nearing 40% casualisation (far higher for early career teachers). We need more, better equipped teachers, not fewer’; teachers who are supported and mentored by more experienced educators, not forced to compete. Our teachers need job security, not ten-month contracts that leave them penniless for a sixth of the year.

Look at the wholesale destruction of our TAFE network – a publicly funded vocational education system that allows the most vulnerable among us to improve their knowledge, skills, employability and careers – young people who have non-academic bents, women re-entering (or entering for the first time) the workforce, migrants, retrenched workers, among many others. That there were problems with previous funding is not in doubt, but privatising the VET sector not only puts education even further out of the reach of those who need it most, it also means even more of the rorting, tick-and-flick programs that leave a growing number of VET students not only unable to access more funding but woefully ill-equipped for the requirements of their chosen field.

Look at the savage cuts to CFA and MFB services, as we approach the worst bushfire season since 2009 – firefighters who’ll be forced to wear second-hand gear as they risk our lives to save ours, and a potential cost to life, limb, property and infrastructure far higher than the $million Premier Baillieu will save.

And that’s the crux of all these governmental decisions – short-term economies that will make the bottom line look good, that will let the Premier crow that the budget’s in surplus, as though money in the bank’s better than money spent of the support and services our communities need. And at what cost?

We know from the Kennett years that it took nursing and midwifery almost a decade to recover numbers back to pre-1992 figures, and that was with nurse/midwife: patient ratios. We know that it costs $100,000 to replace a nurse, far more than the annual salary of retaining a nurse (you can get two graduates for that!), and we know that we’re less than a decade away from a global nursing and midwifery crisis as the profession ages ever closer to retirement.

We know that the best among us, regardless of profession, can find work in other sectors, and other industries – leaving behind the teachers, midwives and educators who can’t do anything else. Buoyed by those of us who choose to do what we love, these professionals can rise – without us we get the health system we see in the UK, where nurses and midwives are so burned out their patient care falls, and falls, and falls.

I have no doubt the same is true for education – and without quality, committed, invested teachers the majority of students won’t learn, won’t be interested in learning, and we will lose a resource we cannot replace.

We know that selling public assets reaps far less money than repurchasing them costs – those buildings TAFEs are being forced to sell can never be regained. That infrastructure, the decades of experience, will be lost to us forever. And that’s before we even consider the wider socioeconomic costs of pulling education further away from those of us who need it most. At a minimum we know there’ll be more welfare, more drug use, more crime, more homelessness, more domestic violence, more single parents (particularly single mothers) and more teenage pregnancies – more poverty, and another generation trapped in the cycle of poverty.

We know that the costs of rebuilding communities destroyed by fire enormously outweighs the costs of maintaining – not even improving – the services we currently have. Just one significant fire this summer will cost our community more than the savings Mr Baillieu thinks he’s making. And that doesn’t come close to reflecting the pain, suffering, medical costs, lives lost, and the ongoing trauma of survivors.

We know, as the ambulance union embarks on EBA negotiations, that ramping at Victoria’s public hospitals in a steadily worsening issue. Every ambulance unable to unload a patient because of Emergency Department acuity means one vehicle and two officers off the road – increasing response times and contributing to burn out and officers leaving their industry. And we know that ANF’s offer to add another nurse to Emergency Departments, a move that would free up to three vehicles and six officers, was rejected by the Baillieu government because it didn’t constitute a nursing productivity gain. Apparently we’re all working in unconnected systems.

And that’s where the Premier and his Party are wrong. We are all connected. We are informed. We communicate. We remember. And in 756 days – we vote.

A couple of days ago I wrote a post about the shameful failure of the Baillieu government to meet the needs of new nurses and midwives by cutting (for the second consecutive year) the number of graduate year positions – a short-sighted cost saving that will affect the provision of nursing and midwifery care in the mid-term (and longer, if this government is re-elected).

I was so incensed by this that I wholly forgot that October 27th is another campaign anniversary – on that day in 2011 ANF Vic. branch launched the first advertisements of the EBA 2011 campaign: Respect Our Work. ANF produced two radio ads featuring ANF Vic, branch State Secretary Lisa Fitzpatrick.

The first addresses ratios, which the government promised to maintain and improve:

I’m Lisa Fitzpatrick, an experienced nurse and Secretary of the ANF, Victorian branch. Our hospitals are overflowing, and demand is increasing. Patients need more nurses and midwives. In most cases it’s just one extra nurse per shift, but despite their promise the government wants to abolish ratios – to save money, not lives. Mr Baillieu, respect our work – don’t ask nurses and midwives to do more with less.

The second addresses the Baillieu government’s proposal to replace qualified nurses with minimally trained aides in Victoria’s acute public hospitals:

I’m Lisa Fitzpatrick, an experienced nurse and Secretary of the ANF, Victorian branch. Our hospitals are overflowing, and demand is increasing. If the Baillieu government replaces experienced nurses with health assistants, current patient care levels will fall and patients will be worse off. The State government’s plan is to save money, not lives. Mr Baillieu, respect our work – don’t ask nurses and midwives to do more with less.

It was the first it what would prove to be ANF (Victoria)’s most media-intensive campaign to date.

Based on the approach this government is taking with teachers, who are in the throes of EBA negotiations, Premier Baillieu has learned nothing from his campaign with us. We, on the other hand, have taken every lesson possible from the experience – not only will we be better prepared come EBA 2016, we’ll use this knowledge in the lead up to the next State election. 758 days, Mr Baillieu – and we won’t forget.